| NPI | 1386727329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN M FITZGERALD Executive Director 703-548-4048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 06303001) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |